Predicting the Effectiveness of a Mindfulness Virtual Community Intervention for University Students: Machine Learning Model.

BACKGROUND: Students' mental health crisis was recognized before the COVID-19 pandemic. Mindfulness virtual community (MVC), an 8-week web-based mindfulness and cognitive behavioral therapy program, has proven to be an effective web-based program to reduce symptoms of depression, anxiety, and stress. Predicting the success of MVC before a student enrolls in the program is essential to advise students accordingly. OBJECTIVE: The objectives of this study were to investigate (1) whether we can predict MVC's effectiveness using sociodemographic and self-reported features and (2) whether exposure to mindfulness videos is highly predictive of the intervention's success. METHODS: Machine learning models were developed to predict MVC's effectiveness, defined as success in reducing symptoms of depression, anxiety, and stress as measured using the Patient Health Questionnaire-9 (PHQ-9), the Beck Anxiety Inventory (BAI), and the Perceived Stress Scale (PSS), to at least the minimal clinically important difference. A data set representing a sample of undergraduate students (N=209) who took the MVC intervention between fall 2017 and fall 2018 was used for this secondary analysis. Random forest was used to measure the features' importance. RESULTS: Gradient boosting achieved the best performance both in terms of area under the curve (AUC) and accuracy for predicting PHQ-9 (AUC=0.85 and accuracy=0.83) and PSS (AUC=1 and accuracy=1), and random forest had the best performance for predicting BAI (AUC=0.93 and accuracy=0.93). Exposure to online mindfulness videos was the most important predictor for the intervention's effectiveness for PHQ-9, BAI, and PSS, followed by the number of working hours per week. CONCLUSIONS: The performance of the models to predict MVC intervention effectiveness for depression, anxiety, and stress is high. These models might be helpful for professionals to advise students early enough on taking the intervention or choosing other alternatives. The students' exposure to online mindfulness videos is the most important predictor for the effectiveness of the MVC intervention. TRIAL REGISTRATION: ISRCTN Registry ISRCTN12249616; https://www.isrctn.com/ISRCTN12249616.

Autism, Stigma, and South Asian Immigrant Families in Canada.

Considerable empirical evidence suggests early recognition of autism and access to support result in long-term positive outcomes for children and youth on the spectrum and their families. However, children of racialized families are often diagnosed at later ages, are more likely to be misdiagnosed, and experience many barriers to service access. There is also a paucity of research exploring the experiences of parents from specific immigrant groups caring for their children on the spectrum in Canada, many of whom identify as members of racialized communities. As such, the main aim of the study was to examine how South Asian immigrant parents in Canada are experiencing available care programs and support. Another aim was to examine their perceptions of social stigma associated with autism. We conducted an inductive thematic analysis of qualitative data from nine interviews with South Asian parents living in Ontario, Canada. Findings confirmed barriers to an autism diagnosis and to service access. Additionally, parents reported pronounced autism stigma, which enacted impediments to timely diagnosis, service access, and health-promoting behaviors. Findings also revealed that parents experience considerable caregiver stress and psychological distress. The generated evidence is anticipated to inform equitable policy, programming, and practices that better support the needs of children on the spectrum and their immigrant families.

Modulation of Altered Immune Parameters IL-2 and TNF-α in Diabetic Animal Models: A Therapeutic Insinuation of Metformin Beyond Diabetes.

BACKGROUND: Immunomodulatory drugs target the overall immune system, hence producing numerous toxic effects on the other organs with serious health manifestations. Due to these safety concerns, there is a need to introduce or repurpose a new drug with immunomodulatory effects with good safety, efficacy, and better tolerance. Metformin, a standard antidiabetic drug, was evaluated for its immunomodulatory effects in diabetic models in the current study. METHODOLOGY: The diabetic model was developed by intraperitoneal (IP) administration of streptozotocin (60 mg/kg). The experimental rats were divided into six groups (three diabetic and three non-diabetic) with six rats in each group. Metformin (50 mg/kg and 80 mg/kg) was given orally to both diabetic and non-diabetic groups, once a day, for 42 days. Immunomodulatory cytokines interleukin (IL)-2, IL-4, IL-5, tumor necrosis factor (TNF)-α, and interferon gamma (INF-É£) were analyzed from blood samples by BD FCAP flow cytometer. RESULTS: The results revealed a significant (p=0.002) decrease in IL-2 and TNF-α in diabetic groups in comparison to control rats. However, no significant changes were observed in IL-4, IL-5, and INF-É£ levels. Importantly, the treatment of metformin at both doses, i.e., 50 and 80 mg/kg, significantly reduced the elevated levels of IL-2 and TNF-α when compared to untreated diabetic groups. CONCLUSION: Metformin may be considered as an optimum drug candidate to reduce pro-inflammatory cytokines, IL-2 and TNF-α, that can lead to the reduction of long-term diabetic complications.

Access to Virtual Mental Healthcare and Support for Refugee and Immigrant Groups: A Scoping Review.

Immigrant and refugee populations face multiple barriers to accessing mental health services. This scoping review applies the (Levesque et al. in Int J Equity Health 12:18, 2013) Patient-Centred Access to Healthcare model in exploring the potential of increased access through virtual mental healthcare services VMHS for these populations by examining the affordability, availability/accommodation, and appropriateness and acceptability of virtual mental health interventions and assessments. A search in CINAHL, MEDLINE, PSYCINFO, EMBASE, SOCINDEX and SCOPUS following (Arksey and O'Malley in Int J Soc Res Methodol 8:19-32, 2005) guidelines found 44 papers and 41 unique interventions/assessment tools. Accessibility depended on individual (e.g., literacy), program (e.g., computer required) and contextual/social factors (e.g., housing characteristics, internet bandwidth). Participation often required financial and technical support, raising important questions about the generalizability and sustainability of VMHS' accessibility for immigrant and refugee populations. Given limitations in current research (i.e., frequent exclusion of patients with severe mental health issues; limited examination of cultural dimensions; de facto exclusion of those without access to technology), further research appears warranted.

Validation of the Malay-Version of Recovery Knowledge Inventory among mental health providers in Malaysia.

Background: The Recovery Knowledge Inventory (RKI) is a widely used self-report instrument that assesses recovery-oriented knowledge among mental health professionals. The purpose of this study is to translate the RKI into the Malay language (RKI-M) and to examine its psychometric properties among Malaysian health care workers. Methods: A cross-sectional study involving 143 participants was conducted at an urban teaching hospital, an urban government hospital, and a rural government hospital. Following the translation of the RKI, its internal reliability was determined using Cronbach's alpha. Construct validity was also determined using confirmatory factor analysis. Results: The Malay-Version RKI (RKI-M) has good internal reliability with a Cronbach's alpha of 0.83. However, the Malay-version RKI failed to replicate the original four-factor structure. The final model only achieved the best model fit after the removal of 9 items with two-factor loadings: (GFI = 0.92; AGFI = 0 0.87; CFI = 0.91; RMSEA = 0.074). Conclusion: The 20-item RKI-M is reliable but has poor construct validity. However, the modified 11-item Malay-version RKI is a more reliable measure as it has good construct validity, with room for future studies to examine the psychometric properties of the modified 11-item RKI among mental health care workers. More training on recovery knowledge should be done, and a simple worded questionnaire should be developed in keeping with local practitioners.

The use of agro-waste-based adsorbents as sustainable, renewable, and low-cost alternatives for the removal of ibuprofen and carbamazepine from water.

The occurrence of residual pharmaceuticals in the aquatic environment poses major toxicological impacts and adds to the increasing pressure on water resources. Many countries are already suffering from water scarcity, and with the burdening costs of water and wastewater treatment, the race towards innovative sustainable strategies for pharmaceutical remediation is ongoing. Out of the available treatment methods, adsorption proved to be a promising, environmentally friendly technique, particularly when efficient waste-based adsorbents are produced from agricultural residues, thus maximizing the value of wastes, minimizing production costs, and saving natural resources from depletion. Among the residual pharmaceuticals, ibuprofen and carbamazepine are heavily consumed and highly occurring in the environment. This paper aims to review the most recent literature on the application of agro-waste-based adsorbents as sustainable alternatives for the removal of ibuprofen and carbamazepine from contaminated waters. Highlights on the major mechanisms implicated in the adsorption of ibuprofen and carbamazepine are presented, and light is shed on multiple operational parameters that hold a key role in the adsorption process. This review also highlights the effects of different production parameters on adsorption efficiency and discusses many limitations currently encountered. Finally, an analysis is included to compare the efficiency of agro-waste-based adsorbents relative to other green and synthetic adsorbents.

Spatio-temporal variation of the microbial community of the coast of Lebanon in response to petroleum hydrocarbon pollution.

In this study, the coast of Lebanon was analyzed for the dynamic changes in sediment microbial communities in response to a major petroleum oil spill and tar contamination that occurred in the summer of 2021. Spatio-temporal variations in the microbial structure along the shores of Lebanon were assessed in comparison to baseline microbial structure determined in 2017. Microbial community structure and diversity were determined using Illumina MiSeq technology and DADA2 pipeline. The results show a significant diversity of microbial populations along the Lebanese shore, and a significant change in the sediment microbial structure within four years. Namely, Woeseia, Blastopirellula, and Muriicola were identified in sediment samples collected in year 2017, while a higher microbial diversity was observed in 2021 with Woeseia, Halogranum, Bacillus, and Vibrio prevailing in beach sediments. In addition, the results demonstrate a significant correlation between certain hydrocarbon degraders, such as Marinobacter and Vibrio, and measured hydrocarbon concentrations.

Antiulcerative potential of sweet potato (Ipomoea batatas) against aspirin-induced gastric ulcers in a rabbit model.

OBJECTIVES: Sweet potato (Ipomoea batatas) is accredited as a functional food because of its nutraceutical compounds. These dietary components may help heal lesions and ulcer scars in the stomach. This research was designed to examine the antioxidant and antiulcerative potential of sweet potato (red skin, white flesh) against aspirin-induced gastric ulcers in a rabbit model. METHODS: Sweet potato samples were analyzed for in vitro analysis, such as 2,2-diphenyl-1-picrylhydrazyl assay, total phenolic content, and total flavonoid content. In a bioefficacy study, rabbits were divided into five groups (n = 6) in which G0 received the standard diet only, G1 150 mg/kg aspirin, G2 20 mg/kg omeprazole, G3 1000 mg/kg aqueous extract of sweet potato, and G4 1000 mg/kg ethanolic extract of sweet potato. After completion of the trial, the animals were decapitated and examined for antiulcer parameters, serum analysis, and hematologic parameters. RESULTS: The mean values for 2,2-diphenyl-1-picrylhydrazyl, total phenolic content, and total flavonoid content were 57%, 927 mg gallic acid equivalent/100 g, and 1901 µg quercetin equivalent/g, respectively. The values for gastric volume, acid output, ulcer scores and index, total oxidant status, white blood cell count, and lymphocyte count were increased significantly (P < 0.05) for the positive control group compared with G2, G3, and G4. Gastric pH and body weight at the end of the experiment were significantly reduced for the positive control group (P < 0.05) compared with G2, G3, and G4. Histology test results of gastric tissues in G1 depicted severe epithelial damage compared with G2, G3, and G4. CONCLUSIONS: The results for the antiulcer parameters ascertained the antiulcer activity of sweet potato in aspirin-induced gastric ulcer models.

Depression Associated With Body Mass Index in Adolescent Girls in a Subset of Karachi Population.

INTRODUCTION: The prevalence of depression is increasing day by day, which predisposes individuals toward significant functional impairment, and increases the risk of suicide and comorbid physical health problems. Body mass index (BMI) and depression are supposed to be associated with each other; however, the effects of depression on body image have not been identified from the perspective of socioeconomic status, which has been considered a major risk factor for the development of depression. Hence, the study was designed to evaluate the prevalence of depression among adults in government schools and to analyze its association with BMI among different socioeconomic statuses. METHODOLOGY: It was a cross-sectional study conducted at two government schools in Shah Faisal colony from September to October 2019. The study participants were girls of age between 11 and 18 years belonging to different socioeconomic statuses, i.e. low, middle, and high. The calculated sample size was 550 which was calculated at 50% proportion of the total population. A self-developed proforma was administered for collecting demographic data, and students' weight and height were noted for calculating BMI. The Patient Health Questionnaire (PHQ) 9 modified depression scale was used to assess the depression among study participants. The chi-square test was applied to check the association between BMI and depression score. The study was approved by the IRB of CPSP Karachi and the reference code ME/HCSM/2019/TWC/G-054 was allotted.  Results: There were 345 (62.7%) participants of age 13-15 years, and most of the participants belonged to middle socioeconomic status, 413 (75%). BMI calculation of study participants showed that 417 (75.8%) scored as underweight and 131 (23.8%) had a normal index. According to the PHQ9 scale, 381 (69.3%) participants were having mild depression and 60 (10.9%) had moderate depression. BMI and depression were not associated significantly with a p-value =0.135. CONCLUSION: The BMI score of study participants seemed to be underweight or normal. The study could not rule out the association of BMI with depression. However, according to the PHQ9 scale score, many participants screened as sufferers of mild to moderate depression, which is alarming, as depression at the age of 11-18 years may predispose young girls to chronic disease and other psychological conditions.

Assessing Virtual Mental Health Access for Refugees during the COVID-19 Pandemic Using the Levesque Client-Centered Framework: What Have We Learned and How Will We Plan for the Future?

During the COVID-19 pandemic, mental health services rapidly transitioned to virtual care. Although such services can improve access for underserved populations, they may also present unique challenges, especially for refugee newcomers. This study examined the multidimensional nature of access to virtual mental health (VMH) care for refugee newcomers during the COVID-19 pandemic, using Levesque et al.'s Client-Centered Framework for Assessing Access to Health Care. One hundred and eight structured and semi structured interviews were conducted in four Canadian provinces (8 community leaders, 37 newcomer clients, 63 mental health or service providers or managers). Deductive qualitative analysis, based on the Client-Centered Framework, identified several overarching themes: challenges due to the cost and complexity of using technology; comfort for VMH outside clinical settings; sustainability post-COVID-19; and communication and the therapeutic alliance. Mental health organizations, community organizations, and service providers can improve access to (virtual) mental health care for refugee newcomers by addressing cultural and structural barriers, tailoring services, and offering choice and flexibility to newcomers.

Interactive mental health assessments for Chinese Canadians: A pilot randomized controlled trial in nurse practitioner-led primary care clinic.

INTRODUCTION: Mental health conditions like depression and anxiety are on the rise, but access to care remains a challenge. Immigrants and racialized communities including Chinese Canadians experience high level of access barriers including communication with clinicians. With the aim to facilitate mental health communications, we tested an Interactive Computer-assisted Client Assessment Survey (iCCAS) in Cantonese/Mandarin and English at a nurse practitioner-led primary care clinic in Toronto. The iCCAS offers a touch-screen, pre-consultation survey with questions on depression, anxiety, post-traumatic stress, alcohol abuse, and social context. The program generates point-of-care reports for the clinician and patient. METHODS: A pilot randomized controlled trial examined the intervention impact on mental health discussion and symptom detection, compared with the usual care, followed by clinicians' qualitative interviews. RESULTS: Fifty self-identified Chinese adult patients participated (iCCAS = 26, Usual Care = 24), response rate 79.4%. Participant mean age was 44.8 years and 92% were immigrants. There was an increase of 19% and 15% in the mental health discussion and detection of symptoms in the iCCAS group compared with the usual care. More participants in the iCCAS group were referred to a social worker or psychiatrist. Patients found the use of iCCAS easy and clinicians identified its benefits for themselves (eg, early identification and comfort) and patients (eg, self-awareness and anonymity) and proposed practice-integration. DISCUSSION: The studied tool holds promise for enhancing clinician-patient mental health communications in primary care settings for overseas Chinese. Implications are discussed for in-person and virtual healthcare which could also inform responses to mental health crisis related to COVID-19.

2020 Syndemic: Convergence of COVID-19, Gender-Based Violence, and Racism Pandemics.

OBJECTIVE: To conduct a rapid knowledge synthesis of literature on the social determinants of mental health of racialized women exposed to gender-based violence (GBV) during the COVID-19 pandemic. METHODS: We adapted the Cochrane Rapid Reviews method and were guided by an equity lens in conducting rapid reviews on public health issues. Four electronic databases (Cochrane CENTRAL, Medline, ProQuest, and EBSCO), electronic news media, Google Scholar, and policy documents were searched for literature between January 2019 and October 2020 with no limitations for location. Fifty-five articles qualified for the review. RESULTS: Health emergencies heighten gender inequalities in relation to income, employment, job security, and working conditions. Household stress and pandemic-related restrictions (social distancing, closure of services) increase women's vulnerability to violence. Systemic racism and discrimination intensify health disparities. CONCLUSION: Racialized women are experiencing a 2020 Syndemic: a convergence of COVID-19, GBV, and racism pandemics, placing their wellbeing at a disproportionate risk. GBV is a public health issue and gender-responsive COVID-19 programming is essential. Anti-racist and equity-promoting policies to GBV service provision and disaggregated data collection are required.

Perspectives of older Tamil immigrants on social inclusion: A concept mapping study in Canada.

Evidence shows that immigrants face several challenges post migration, impacting their social inclusion. Yet, limited scholarly knowledge exists on older immigrants including Tamils from Sri Lanka. Thus, an exploratory concept mapping (CM) study was conducted in 2017 with 27 Tamil immigrant women and men aged ≥55 years and settled in Toronto, Canada. The aim was to gather their perspectives on factors that help them to feel socially included (focal question). The CM methodology first engaged participants in brainstorming sessions to generate ideas in response to the focal question. Participants then joined sorting and rating sessions and sorted 72 generated items and rated them on a scale of 1-5 for importance and feasibility to initiate a change. Finally, in the interpretation session, participants provided feedback on the visual cluster maps generated through quantitative analysis of the collected data. Participants labelled the seven identified clusters: (a) Services for Employment and Settlement; (b) Financial Independence; (c) Medical System and Senior Care; (d) Adaptation and Integration; (e) Family Harmony; (f) Cultural Interaction and Feeling of Security; and (g) Social Interaction. The clusters one to three were at the top for importance (mean 4.33, 4.22, 4.17) and participants interpreted these as needing policy-level attention (e.g. credential evaluation, hiring practices) and identified the roles of advocacy and community-engagement for community-based programmes (CBPs). The Family Harmony was interpreted as needing 'work within families', while CBPs' culturally sensitive outreach was viewed as valuable. Participant interpretation of other clusters highlighted the role of social networking, trust, belonging, civic engagement and social cohesion through joint working of the community members and CBPs. The findings call for an inter-sectoral and community-engaged approach to strengthen the social inclusion of the community. Future research with a larger sample is needed, especially on early settlement experiences and social inclusion of older immigrants.

Intensification in Genetic Information and Acquisition of Resistant Genes in Genome of Acinetobacter baumannii: A Pan-Genomic Analysis.

Acinetobacter baumannii (A. baumannii) attributes 26% of the mortality rate in hospitalized patients, and the percentage can rise to 46 in patients admitted to ICU as it is a major cause of ventilator-associated pneumonia. It has been nominated as the critical priority organism by WHO for which new therapeutic drugs are urgently required. To understand the genomic identification of different strains, antimicrobial resistance patterns, and epidemiological typing of organisms, whole-genome sequencing (WGS) analysis provides insight to explore new epitopes to develop new drugs against the organism. Therefore, the study is aimed at investigating the whole genome sequence of A. baumannii strains to report the new intensifications in its genomic profile. The genome sequences were retrieved from the NCBI database system. Pan-genome BPGA (Bacterial Pan-genome Analysis Tool) was used to analyze the core, pan, and species-specific genome analysis. The pan and core genome curves were extrapolated using the empirical power law equation f(x) = a.xb and the exponential equation f1(x) = c.e (d.x). To identify the resistant genes with resistant mutations against antibiotics, ResFinder and Galaxy Community hub bioinformatics tools were used. According to pan-genome analysis, there were 2227 core genes present in each species of the A. baumannii genome. Furthermore, the number of accessory genes ranged from 1182 to 1460, and the unique genes in the genome were 931. There were 325 exclusively absent genes in the genome of Acinetobacter baumannii. The pan-genome analysis showed that there is a 5-fold increase in the genome of A. baumannii in 5 years, and the genome is still open. There is the addition of multiple unique genes; among them, genes participating in the function of information and processing are increased.

The impact of COVID-19 on the mental health and wellbeing of caregivers of autistic children and youth: A scoping review.

Caregivers and families of autistic people have experienced stress and increase in demands due to the COVID-19 pandemic that may have long-term negative consequences for both their own and their children's mental health. A scoping review was conducted to identify pandemic related demands experienced by caregivers and families of autistic children and youth. The review also consolidated information on coping strategies and parenting-related guidelines that have emerged to help parents meet these demands. Search strategies were approved by a research librarian and were conducted in peer-reviewed and gray literature databases between May 2020 and February 2021. Additional resources were solicited through author networks and social media. All articles were published between December 2019 and February 2021. Article summaries were charted, and a thematic analysis was conducted with confirmation of findings with our knowledge users. Twenty-three published articles and 14 pieces of gray literature were included in the review. The majority of articles characterized and highlighted the increase in demands on caregivers of autistic children and youth during the pandemic globally. Both quantitative and qualitative studies suggest that parents have experienced an increase in stress and mental health-related symptoms during lockdown measures. Findings suggest that families are employing coping strategies, but there no evidence-based supports were identified. The review highlighted the potential long-term impact of prolonged exposure to increasing demands on the mental health and wellbeing of caregivers and families of autistic people, and pointed to a need for the rapid development and evaluation of flexible and timely support programs. LAY SUMMARY: Caregivers and families of autistic children and youth have faced increased demands due to pandemic-related lockdown measures. We reviewed the literature to outline sources of stress, links to their influence on caregiver mental health, and if support programs have emerged to help them. Our findings suggest a number of demands have increased caregivers' risk to mental health challenges, and their potential impact on family wellbeing. Ongoing development of evidence-based supports of all families of autistic children and youth are needed.

Medicinal Plants with Anti-Leukemic Effects: A Review.

Leukemia is a leukocyte cancer that is characterized by anarchic growth of immature immune cells in the bone marrow, blood and spleen. There are many forms of leukemia, and the best course of therapy and the chance of a patient's survival depend on the type of leukemic disease. Different forms of drugs have been used to treat leukemia. Due to the adverse effects associated with such therapies and drug resistance, the search for safer and more effective drugs remains one of the most challenging areas of research. Thus, new therapeutic approaches are important to improving outcomes. Almost half of the drugs utilized nowadays in treating cancer are from natural products and their derivatives. Medicinal plants have proven to be an effective natural source of anti-leukemic drugs. The cytotoxicity and the mechanisms underlying the toxicity of these plants to leukemic cells and their isolated compounds were investigated. Effort has been made throughout this comprehensive review to highlight the recent developments and milestones achieved in leukemia therapies using plant-derived compounds and the crude extracts from various medicinal plants. Furthermore, the mechanisms of action of these plants are discussed.

Risk Factors Associated with Multiple Sclerosis: A Case-Control Study in Damascus, Syria.

OBJECTIVES: To assess the probable risk factors associated with Multiple sclerosis among Syrian patients in the city of Damascus. METHOD: In a case-control study conducted from May to September 2020, 140 MS patients and 140 healthy controls were selected from two main hospitals in Damascus. Data regarding risk factors associated with MS was collected via a structured questionnaire and complementary laboratory tests. The statistical analysis was carried out by the SPSS Statistical Software Version 26. RESULTS: Factors such as smoking, family history of MS, migraine, and vitamin D deficiency were associated with a higher risk of developing MS: Smoking (OR = 2.275 95% CI (1.348-3.841) P = 0.002). Family history of MS (OR = 3.970 95% CI (1.807-8.719) P ≤ 0.001). Migraine (OR = 3.011 95% CI (1.345-6.741) P = 0.005). Vitamin D deficiency (OR = 4.778 95% CI (2.863-7.972) P ≤ 0.001). However, factors such as diabetes, hypertension, a surgical history of appendectomy, tonsillectomy, and being the first-born in a family were statistically irrelevant: Diabetes (OR = 0.652 95% CI (0.226-1.882) P = 0.426). Hypertension (OR = 1.445 95% CI (0.724-2.885) P = 0.295) Appendectomy (OR = 1.269 95% CI (0.486-3.317) P = 0.626) Tonsillectomy (OR = 1.280 95% CI (0.576-2.843) P = 0.544). First-born Child (OR = 0.933 95% CI (0.558-1.562) P = 0.793). CONCLUSION: Our study suggests that smoking, vitamin D deficiency, family history of MS, and migraine are probable risk factors for multiple sclerosis. Therefore, engaging in outdoor activities and maintaining a healthy diet-for females in particular-is highly recommended.

Cereal processing waste, an environmental impact and value addition perspectives: A comprehensive treatise.

This review is to describe various methods used for the treatment of cereal processing wastes and their efficiency to reduce environmental issues. Physico-chemical and biological methods have great potential for the treatment of cereal industrial waste. These methods can be used alone or in combination with effective treatment. Physico-chemical treatments are mostly employed for the pretreatment of cereal processing wastes that helps in reduced sludge formation during biological treatments. Biological treatments are mostly used owing to their high efficiency in removing pollutants, and less expensive than physico-chemical treatments. However, these treatments consume more time as compared to physico-chemical treatments. These treatments also proved to be efficient for a high rate of cereal waste conversion into value-added products. Thus, cereal industrial waste can result in value-added products such as biohydrogen, bioethanol, butanol, biogas and biocoal as biofuels, industrial valued enzymes, biomass, biofertilizer, proteins, organic acids, polysaccharides and few others.

Association amid the comorbidity of Diabetes Mellitus in patients of Active Tuberculosis in Pakistan: A matched case control study.

OBJECTIVES: This study aims to test the association between diabetes and tuberculosis. METHODS: It is a matched case control study conducted in tertiary care hospitals in 2019-2020. Cases and controls were 144 each, selected on the basis of an odds ratio of 2 at 95% confidence interval with a significance level of 5%. Cases of pulmonary tuberculosis were selected through consecutive sampling technique, either visiting OPD or admitted in hospital. Controls were taken from the general population and frequency matching was done based on age, gender and socioeconomic status. Data was collected through structured questionnaire after taking written consent. Data was analyzed on SPSS version 23. Binary Logistic regression model was applied for finding association between the risk factors and the disease. P value <0.05 was considered statistically significant. RESULTS: Out of all cases and controls, 45% and 20% were diabetics respectively. The association between the risk factors and tuberculosis was estimated by univariate analysis, positive association was found between diabetes and tuberculosis (OR= 3.32), a high frequency of diabetes in cases as compared to controls were observed with a highly significant p- value (<.001). CONCLUSIONS: This study provides evidence for a strong positive association between tuberculosis and diabetes.